Paudel G R, Agrawal C S, Regmi R, Agrawal S
Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
JNMA J Nepal Med Assoc. 2010 Oct-Dec;50(180):295-9.
Acute appendicitis is one of the commonest surgical problems and appendectomy is one of the most commonly done operations in the emergency world wide. Though there have been occasional reports with conservative treatment in acute appendicitis, it is not being practiced as a routine.
All patients between ten to sixty years of age admitted at BPKIHS with the diagnosis of acute appendicitis over a period of one year were enrolled in the study. After taking informed consent the patients were managed conservatively. Those who did not respond to antibiotics within 24 hours were operated. Total hospital stay and complications were recorded and they were followed up at first week, sixth week and sixth month. The success rate, conversion rate, recurrence rate and morbidity and mortality pattern were assessed as the final outcome of conservative treatment of acute appendicitis.
A total of 96 patients (48 males and 48 females) underwent conservative treatment. The conservative treatment was successful in 79 (82.3%) cases and failed in 11 (11.4%) cases, which included: conversion to appendectomy during conservative treatment period 4 (4.2%) cases, recurrence 7 (7.3%) cases. There was no mortality in this study.
Acute appendicitis can be treated successfully with conservative (antibiotics) treatment with a short hospital stay. Though there is a risk of recurrence in some cases, all the complications after appendectomy can be eliminated with the conservative treatment.
急性阑尾炎是最常见的外科问题之一,阑尾切除术是全球急诊中最常进行的手术之一。尽管偶尔有关于急性阑尾炎保守治疗的报道,但尚未将其作为常规方法应用。
纳入在BPKIHS医院确诊为急性阑尾炎、年龄在10至60岁之间、为期一年的所有患者。在获得知情同意后,对患者进行保守治疗。那些在24小时内对抗生素无反应的患者接受手术治疗。记录患者的总住院时间和并发症情况,并在第一周、第六周和第六个月进行随访。评估保守治疗急性阑尾炎的成功率、中转率、复发率以及发病率和死亡率模式作为最终结果。
共有96例患者(48例男性和48例女性)接受了保守治疗。保守治疗成功79例(82.3%),失败11例(11.4%),其中包括:在保守治疗期间中转行阑尾切除术4例(4.2%),复发7例(7.3%)。本研究中无死亡病例。
急性阑尾炎采用保守(抗生素)治疗可成功治愈,住院时间短。尽管某些情况下存在复发风险,但保守治疗可消除阑尾切除术后的所有并发症。